PROJECT SUMMARY In the US, roughly 1 in 5 children experience a mental health problem severe enough to warrant intervention; 70-80% of them receive treatment in the education sector. However, schools are often unable to deliver high- quality evidence-based treatments. The goal of this project is to improve the quality of school-based mental health (SMH) services by leveraging health information technology to facilitate measurement-based care (MBC)?an evidence based practice that utilizes client or caregiver reported data to monitor treatment progress and inform clinical decision-making. MBC has consistently been shown to improve mental health treatment outcomes for youth and adults, leading to faster recovery. Although MBC is not routinely used in schools, our prior work has found that digital measurement feedback systems, which gather client-generated treatment outcome data and deliver results to clinicians, can facilitate MBC. Despite increasingly widespread use in specialty mental health settings, no commercially available measurement feedback systems have been developed or adapted for use in the school context. Given the compelling evidence for the effectiveness of MBC, the broad influence of SMH, and the current lack of measurement feedback systems designed for schools, we propose to adapt and market a measurement feedback system known as OwlOutcomes? (or Owl) for SMH. Using the Contextualized Technology Adaption Process, which details a sequence of phases for adapting existing health information technology to novel settings, and incorporating user-centered design methodology, which emphasizes iterative development of parsimonious and compelling products, the current proposal will maximize the usability, compatibility, and utility of an innovative product?Owl for Schools (Owl-S)?to optimally support the implementation of MBC in schools. In Aim 1, (a) an evaluation of the implementation context (i.e., SMH) and (b) an assessment of the un-adapted Owl via lab-based usability testing with SMH clinicians will inform the adaption of Owl for SMH; (c) an evaluation of the usability, compatibility, and utility of the modified Owl (Owl-S) via in vivo field testing will identify additional adaptations needed. In Aim 2, a pilot randomized trial of the fully adapted Owl-S will assess (a) the impact of access to Owl-S on SMH clinicians? use of measurement-based care, as well as (b) Owl-S? ease of implementation in SMH as indicated by school clinicians? rating of its usability, compatibility and utility. The completion of these Aims will result in a measurement feedback system adapted for SMH use, that is easily implementable (Aim 2b) and effective in increasing MBC use (Aim 2a) and thus improving SMH care quality. The ~14,000 school districts in the US represent a total addressable market of $17.5M per annum, based on a SaaS model and an annual subscription fee of $250/clinician (~5 per district). This STTR will support the product adaptation and validation of Owl-S and in so doing create an innovative product that will fill a need in a very large and currently untapped market, with the ultimate goal of improving the public health impact of school-based mental health.